Single-pill combination of cilnidipine, an L-/N-type calcium channel blocker, and valsartan effectively reduces home pulse pressure in patients with uncontrolled hypertension and sympathetic hyperactivity: The HOPE-Combi survey.

Abstract

The home blood pressure (BP) control by a single-pill combination of cilnidipine (an L-/N-type calcium channel blocker; CCB) and valsartan (HOPE-Combi) survey is a multicenter, post-marketing, prospective observational study of a single-pill combination of cilnidipine 10mg and valsartan 80mg (SPC of Cil/Val) in patients with uncontrolled hypertension. We examined the effects of the SPC of Cil/Val on morning home systolic BP (MHSBP) and morning home pulse pressure (MHPP) of 1036 patients with hypertension over 12months. MHSBP decreased by 14.0mm Hg (P<.01), and MHPP decreased by 6.6mm Hg (P<.01). Moreover, morning home pulse rate (MHPR) decreased by 2.1bpm (P<.01). A more progressive and greater decrease in MHSBP (-17.2 vs -10.3mm Hg, P<.01) and MHPP (-7.6 vs -4.9mm Hg, P<.01) was observed in patients with higher MHPR (≥70bpm) than in those with lower MHPR (<70bpm) over the treatment period. In particular, in patients with a wide MHPP (≥70mm Hg), the difference in the MHPP reduction was greater in patients with higher MHPR than in those with lower MHPR (-17.9 vs -13.6mm Hg, P<.01). These results suggested that the SPC of Cil/Val, which possesses the unique sympatholytic characteristics of an L-/N-type CCB, was particularly effective in patients with uncontrolled hypertension and sympathetic hyperactivity.